ObamaCare

Perhaps you remember the “clever” accounting trick (also known as double counting) that the Democrats used to claim that ObamaCare would save money?

You know, it would cut Medicare by 500 billion (after the election, of course). You were supposed to believe that was a net cut in spending, remember? Of course it wasn’t. It was simply shifting the money to “pay” for other areas of ObamaCare. There was no “net” savings.

Well the newest projection by the CBO is that it will actually be 716 billion over 10 years (2013 to 2022) and it will essentially gut Medicare. Of course the old folks will have voted before it goes into effect.

A $156 billion cut in payment rates in Medicare Advantage (MA); $156 billion is before considering interactions with other provisions. The House Ways and Means Committee was able to include interactions with other provisions, estimating the cuts to MA to be even higher, coming in at $308 billion.

$56 billion in cuts for disproportionate share hospital (DSH) payments.* DSH payments go to hospitals that serve a large number of low-income patients.

$114 billion in other provisions pertaining to Medicare, Medicaid, and CHIP* (does not include coverage-related provisions).

*Subtract $25 billion total between DSH payments and other provisions for spending that was cut from Medicaid and CHIP.

The effect will be fairly substantial and should be obvious to even the most staunch ObamaCare supporter:

The impact of these cuts will be detrimental to seniors’ access to care. The Medicare trustees 2012 report concludes that these lower Medicare payment rates will cause an estimated 15 percent of hospitals, skilled nursing facilities, and home health agencies to operate at a loss by 2019, 25 percent to operate at a loss in 2030, and 40 percent by 2050. Operating at a loss means these facilities are likely to cut back their services to Medicare patients or close their doors, making it more difficult for seniors to access these services.

In addition, as MA deteriorates under Obamacare’s cuts, many of those who are enrolled in MA (27 percent of total Medicare beneficiaries) will lose their current health coverage and be forced back into traditional Medicare, where Medicare providers will be subject to further cuts. The Centers for Medicare and Medicaid Services chief actuary predicted in 2010 that enrollment in MA would decrease 50 percent by 2017, when Obamacare’s cuts were estimated at only $145 billion. Now that the cuts have been increased to $156 billion (or possibly $308 billion, as the Ways and Means Committee estimates), MA enrollment will surely decrease even further.

But Obamacare’s raid of Medicare doesn’t stop with cuts; it includes a redirection of tax revenue from the Medicare payroll tax hike in Obamacare. The payroll tax funds Medicare Part A, the trust fund that is projected to become insolvent as soon as 2024. Obamacare increases the tax from 2.9 percent to 3.8 percent, which is projected to cost taxpayers $318 billion from 2013 to 2022. However, for the very first time, Obamacare does not use the tax revenue from the increased Medicare payroll tax to pay for Medicare; the money is used to fund other parts of Obamacare, much like the $716 billion in cuts are.

That in addition to the fact that Medicare still has 37 trillion in unfunded mandates.

Also note the tax increase in the last paragraph (yes, that would be a middle class tax increase) and how the funds will not support the program with the 37 trillion problem.

Now we can argue all we want about the existence or non-existence of “death panels”, but here we have exactly what was predicted prior to this abortion of a law being passed. Rationed care (“… cut back services to Medicare patients or close their doors, making it more difficult for seniors to access these services.”) driven by these cost cuts are defacto “death panels”.

As the Foundry concludes:

With a raid on Medicare of this magnitude, President Obama’s assertion that his new law is protecting seniors and Medicare is astonishing. The truth is that Obamacare does the opposite.

But hey, this is the same President who claims his economic policy is working too. See previous post for the reality of that claim.

The reason this cut takes place in 2013 is obvious. If seniors were aware of its impact, you know how they’d vote.

Whether you do or don’t support Medicare isn’t the point, it’s the bald faced lies that have been put forward claiming something that isn’t at all true. And now the numbers are out that prove that.

Again, something which should be front and center as a major issue in this political season.

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Yesterday, as the Republican controlled House of Representatives voted for the 30th time to repeal ObamaCare, Nancy Pelosi said:

“We put forth a vision for the middle class to make health care a right, not a privilege for all Americans. Today, as they have done more than 30 times this Congress, Republicans will vote to take away that right.”

Pelosi, among many of our legislators and politicians in general, displays a level of ignorance about rights and privileges that seems pretty basic to me. Governments don’t grant rights, they grant privileges no matter how hard they try to characterize what they do as a “right”.

A right, to be a right, must be inherent. It is something you have even before government shows up. The right to life. The right to liberty. As our founders identified these rights, they’re “inalienable”.

The best government can do, and the true foundation of a just government, is the acknowledge and protect our inherent rights. I.e government should exist to protect those rights.

Real rights are passive. They don’t require the assets, time, labor or commitment of others to enable their execution. Health care, of course, is a perfect example of a pseudo“right” which requires all of that.

Anything that government can give you (remember, we had the inherent rights I talk about before government existed and we formed the government to acknowledge and protect them – see founding documents) is not a “right.” And when government has to use it’s coercive power to “enable” these pseudo “rights” as it has in this health insurance debacle, it isn’t a right.

There is no right to health care. Period. There never has been. You have no inherent right to demand someone else use their skills, time and assets to service your health. You certainly have the right to negotiate and reach a voluntary agreement (see liberty) with health care providers based on a mutual exchange of value (see property). But “right” – no.

And besides, what Pelosi et al really cranked out was a requirement to buy health insurance via the coercive taxing authority of government. It no more guarantees health care as a right than the previous system. You still have to find a health care provider to accept your insurance and agree to treat you. In fact, it’s even tough to characterize the ObamaCare monstrosity as a government granted “privilege”.

Back to the point – this fundamental ignorance about rights and privileges, however, is at the root of many of our problems. For decades we’ve allowed government to get away with calling things it grants “rights” to the point that the concept of rights is so muddled that most people don’t understand them at all and have fallen for the government line.

Falling for that line helps enable horrific legislation like ObamaCare because it gives it cover, a veneer of "good” the proponents use to push their agenda. Who wouldn’t be for something that’s a “right”?

My point: Don’t let them misuse the word. Call people and politicians who do this out. Make them substantiate their claim of a right and when they can’t point out what is really going on. They’re talking about a privilege established by government coercion. That’s not freedom. That’s not liberty, two things you have a right to expect and something these privileges usually curtail.

It’s time to take back the political language. And there’s no better place to start with the understanding that government’s don’t and can’t grant rights.

President Obama is on his newest attempt to change the subject and find something to take to the people that might interest them and distract from his abysmal economic performance. It’s taxes. Specifically, he’s decided to make an issue of the automatic tax increases that will take effect in January and claim he does not want to see taxes increase on anyone but those nasty rich who need to “pay their fair share”. Or, back to class warfare.

A) He likes to refer to these as the “Bush tax cuts”. In fact, they’re the current tax rate. Have been for years. What he wants to do is see a tax increase on the rich, but no one else. I’m not sure how else one characterizes that but “class warfare”, especially given the percentage of total taxes that top income group pays already.

B) Republicans are saying no tax increases on anyone. Democrats like to characterize that as protecting the rich. I like to characterize it as an attempt to address the real problem – out of control government spending.

C) The nasty “rich” Obama wants to tax also include almost a million small businesses. That’s one of the primary reasons, in this weakening economy, that Republicans are right not to agree to any tax increases. It is both stupid and economically suicidal. But then you have to know about economics and the business world to understand that.

D) Democrats had two years of a complete monopoly on government to get this done and didn’t. It’s not the Republicans who have prevented anything. It is total incompetence on the Democratic side of the aisle. And, as Obama’s favorite pastor likes to say, “those chickens are coming home to roost”.

E) Finally, Barack Obama has already raised taxes on the middle class despite his statement in a speech yesterday claiming he had no desire to raise middle class taxes.

The tax is called the mandate in ObamaCare. It goes like this:

75% of the mandate tax falls on the middle class. That is a middle class tax hike in anyone’s book.

So when he claims he has no desire to raise the taxes on the middle class, that may be true … now. Because, in fact, he’s already done it.

I’ve read all the pundits and listened to all the talking head elite tell us how incredibly nuanced and subtle the Chief Justice was by approving the law as a tax. In fact one described him as “"a chess master, a statesman, a Burkean minimalist, a battle-loser but war-winner, a Daniel Webster for our times."

I say “BS”. He sold out. He ended up being more worried about the perception of the court and his legacy than upholding the Constitution of the United States. And I’m not the only one who feels that way. The Wall Street Journal also throws a punch or two at Roberts:

His ruling, with its multiple contradictions and inconsistencies, reads if it were written by someone affronted by the government’s core constitutional claims but who wanted to uphold the law anyway to avoid political blowback and thus found a pretext for doing so in the taxing power.

If this understanding is correct, then Chief Justice Roberts behaved like a politician, which is more corrosive to the rule of law and the Court’s legitimacy than any abuse it would have taken from a ruling that President Obama disliked. The irony is that the Chief Justice’s cheering section is praising his political skills, not his reasoning. Judges are not supposed to invent political compromises.

"It is not our job," the Chief Justice writes, "to protect the people from the consequences of their political choices." But the Court’s most important role is to protect liberty when the political branches exceed the Constitution’s bounds, not to bless their excesses in the interests of political or personal expediency or both. On one of the most consequential cases he will ever hear, Chief Justice Roberts failed this most basic responsibility.

Precisely. And Roberts caved. From the lecture the court got from Obama during a State of the Union address till now, he became a cautious old lady more concerned with his reputation in perpetuity than serving the people and the Constitution he swore to uphold.

That, as the WSJ says, is “more corrosive to the rule of law and the Court’s legitimacy” than anything he could have done. He didn’t have the spine to take the heat from a controversial but proper decision so he took the easy way out. He threw away his integrity for popularity and peace. A judicial Chamberlin if you will.

The Journal notes that the tax power endorsed by Roberts is no less sweeping and dangerous to liberty than the Commerce Clause argument he rejected. "From now on," it says, "Congress can simply regulate interstate commerce by imposing ‘taxes’ whenever someone does or does not do something contrary to its desires." Worse, as I pointed out last week, the tax trick allows Congress to dispense with claims about interstate commerce altogether. As long as a mandate is disguised as a tax (and as long as it does not violate explicit limits on federal power such as those listed in the Bill of Rights), "because we said so" is reason enough.

Mandates “disguised as a tax” give Congress almost limitless power to control your life. That is the power Roberts handed our elected officials.

Oh, but the apologists say, that will never happen. They’d never abuse that power. Yeah, a little lesson in history. When the Constitutional amendment for the income tax was being debated some wanted to put a 2% limit on it. “Don’t do that,” the others said, “it will encourage Congress to immediately go that high.”

And here we are.

The Congress no longer need wrestle with intrusion in your life via the Commerce clause. Justice Roberts just gave them an infinitely easier route that doesn’t require a Constitutional check. He effectively removed the Court from its role in protecting you from increasing government intrusion.

And clever politicians will find a way to use that power he handed them when necessary. Don’t you ever doubt that.

As for Roberts. I have little or no use for a man who sits on the bench of the Supreme Court and puts politics in front of the Constitution he’s sworn to uphold.

2. Codification of the “economic substance doctrine” (Tax hike of $4.5 billion). This provision allows the IRS to disallow completely-legal tax deductions and other legal tax-minimizing plans just because the IRS deems that the action lacks “substance” and is merely intended to reduce taxes owed. Bill: Reconciliation Act; Page: 108-113

5. Blue Cross/Blue Shield Tax Hike ($0.4 bil/Jan 2010): The special tax deduction in current law for Blue Cross/Blue Shield companies would only be allowed if 85 percent or more of premium revenues are spent on clinical services. Bill: PPACA; Page: 2,004

No actual number but let’s just say “billions and billions” as the middle class gets taxed for its health benefits. Next year (2013), these kick in:

10. Surtax on Investment Income ($123 billion/Jan. 2013): Creation of a new, 3.8 percent surtax on investment income earned in households making at least $250,000 ($200,000 single). This would result in the following top tax rates on investment income: Bill: Reconciliation Act; Page: 87-93

Also known as a “tax on the rich”. To what effect? Well in 2012 capital gains is taxed at 15%, dividends at 15% and “other” at 35%. If you’re wondering what constitutes “other” here’s how it is defined:

*Other unearned income includes (for surtax purposes) gross income from interest, annuities, royalties, net rents, and passive income in partnerships and Subchapter-S corporations. It does not include municipal bond interest or life insurance proceeds, since those do not add to gross income. It does not include active trade or business income, fair market value sales of ownership in pass-through entities, or distributions from retirement plans. The 3.8% surtax does not apply to non-resident aliens.

In 2013 capital gains will be taxed at 23.8%, dividends at 43.4% and “other” at 43.4%.

13. Raise "Haircut" for Medical Itemized Deduction from 7.5% to 10% of AGI ($15.2 bil/Jan 2013): Currently, those facing high medical expenses are allowed a deduction for medical expenses to the extent that those expenses exceed 7.5 percent of adjusted gross income (AGI). The new provision imposes a threshold of 10 percent of AGI. Waived for 65+ taxpayers in 2013-2016 only. Bill: PPACA; Page: 1,994-1,995

14. Flexible Spending Account Cap – aka “Special Needs Kids Tax” ($13 bil/Jan 2013): Imposes cap on FSAs of $2500 (now unlimited). Indexed to inflation after 2013. There is one group of FSA owners for whom this new cap will be particularly cruel and onerous: parents of special needs children. There are thousands of families with special needs children in the United States, and many of them use FSAs to pay for special needs education. Tuition rates at one leading school that teaches special needs children in Washington, D.C. (National Child Research Center) can easily exceed $14,000 per year. Under tax rules, FSA dollars can be used to pay for this type of special needs education. Bill: PPACA; Page: 2,388-2,389

17. Individual Mandate Excise Tax (Jan 2014): Starting in 2014, anyone not buying “qualifying” health insurance must pay an income surtax according to the higher of the following:

Of course, there are exemptions (Catholics need not apply regardless of what it says):

Exemptions for religious objectors, undocumented immigrants, prisoners, those earning less than the poverty line, members of Indian tribes, and hardship cases (determined by HHS).Bill: PPACA; Page: 317-337

“Undocumented immigrants” get a bye … more of the DREAM Act?

18. Employer Mandate Tax (Jan 2014): If an employer does not offer health coverage, and at least one employee qualifies for a health tax credit, the employer must pay an additional non-deductible tax of $2000 for all full-time employees. Applies to all employers with 50 or more employees. If any employee actually receives coverage through the exchange, the penalty on the employer for that employee rises to $3000. If the employer requires a waiting period to enroll in coverage of 30-60 days, there is a $400 tax per employee ($600 if the period is 60 days or longer).Bill: PPACA; Page: 345-346

At this point, we’re very near if not past half a trillion dollars in new taxes.

Never mind the perverse incentives Dale outlines in his post about ObamaCare and the fact that they’ll work very hard to make it one of the largest failures in American history. Imagine the horrific effect these taxes will have on the middle class, on investment, on innovation and, frankly, on the level of care. Not to mention the drain on a very shaky economy (and the possibility of Taxmageddon hitting as well).

This is the pig-in-the-poke a Democratic Congress passed and the Supreme Court upheld yesterday.

OK, we now have Obamacare. Absent a November election of Mitt Romney and Republican congressional majorities, we’ll simply have to live with it. Except, of course, we won’t, because Obamacare simply will not work. Its design practically ensures that it will meet none of the goals its proponents claim it will meet. The end result will inevitably be more people uninsured, higher costs, greater government spending, and higher debt.

If you want to see how a policy will work, then ignore all the claims made by it’s proponents—and opponents. All that is necessary is to look closely at the incentive structures the law creates. Those incentives will tell you how people will respond to the policy.

So, let’s take a brief look at just a few of the incentives Obamacare creates.

First, health plans are more highly regulated. They must cover a wide range of preventative procedures, like pediatric or maternity care. This means that stand-alone catastrophic coverage will essentially be a thing of the past. This increases the cost of premiums across the board, and eliminates an entire class of individual insurance coverage.

At the same time, insurers are forced to cover pre-existing conditions, with premiums limited to 2.5x that of the lower-risk groups. People with chronic conditions, such as diabetes, generally incur costs far in advance of 2.5x that of healthy people—as I well know, being diabetic—and the care for the seriously ill, such as cancer patients, is far higher still. This will, again, raise the costs of premiums overall to recoup the extra costs of insuring the chronically or seriously ill.

Individuals who do not have have health coverage will be forced to pay what we learned this morning was a tax to the IRS instead. Rational people, then will choose not to buy insurance until their health costs + the penalty is greater than the cost of a health plan.

Lower income people, with a family income of less than 400% of the poverty level ($88,000 for a family of four) receive a subsidy of varying value, declining with income increases until the 400% of poverty level, at which point it drops to $5,000. At 401% of the poverty level, the subsidy ends. So at that $88,000 level, any increase of income results in the loss of $$5,000. At that point, it is uneconomic to accept any increase in income to less than $93,000, as it will result in a net loss of income, or the family will have to forego medical insurance. This will trap low-wage workers.

Companies with less than 50 employees that currently provide health coverage to their workers will face a broad range of new costs, mandates, regulations and coverage mandates. They will have to either require more costs to be paid by employees, or simply drop health coverage altogether and simply pay a nominal tax penalty. I suspect many companies will choose the latter, thereby forcing employees to pay for higher-cost individual plans, or forego coverage. Even worse, companies that employ fewer than 50 people have a huge incentive to ensure they never have more than 50 people on the payroll, lest they then be required to provide health insurance, and subject themselves to a much higher administrative burden.

These perverse incentives will result in higher health insurance costs, and an increase in the number of uninsured people. Additionally, the macroeconomic incentives will result in less income growth and lower employment. We will then be told that the "free market" has failed yet again, and be forced to submit to a fully government-run health care system.

Ultimately, Obamacare is nothing more than the latest in "a long train of abuses and usurpations" about which we have done nothing, and will do nothing. I mean, let’s face it, no one is going to call for a new constitutional convention, much less get together with a lusty, gusty group of fellows and head off into the hills with rifles.

But, there’s always a silver lining to every cloud. In this case, it’s that when we default on or monetize our debt and destroy the currency and economy, Obamacare will be irrelevant, as there will barely be enough money for food and shelter, much less expansive health coverage programs.

Apparently the entire law has been upheld with Chief Justice John Roberts joining the liberal side of the court to declare the individual mandate survives as a tax. The political elite have once again wiped their collective rear ends with the Constitution.

You are now all destined to be required by law to purchase (via “tax”) whatever in the hell Congress decides it wants you to purchase. And this will, of course, translate into doing whatever Congress decides you need to do (again, I’m sure the clever totalitarians among us will find some way to accomplish those things through “taxation”).

The court reinforces that individuals can simply refuse to pay the tax and not comply with the mandate.

Hmmm …

CNN just corrected their previous release and said the entire ACA had been upheld (and they wonder why they’re losing viewers?).

More SCOTUSblog:

The Court holds that the mandate violates the Commerce Clause, but that doesn’t matter b/c there are five votes for the mandate to be constitutional under the taxing power.

SCOTUSblog again:

In Plain English: The Affordable Care Act, including its individual mandate that virtually all Americans buy health insurance, is constitutional. There were not five votes to uphold it on the ground that Congress could use its power to regulate commerce between the states to require everyone to buy health insurance. However, five Justices agreed that the penalty that someone must pay if he refuses to buy insurance is a kind of tax that Congress can impose using its taxing power. That is all that matters. Because the mandate survives, the Court did not need to decide what other parts of the statute were constitutional, except for a provision that required states to comply with new eligibility requirements for Medicaid or risk losing their funding. On that question, the Court held that the provision is constitutional as long as states would only lose new funds if they didn’t comply with the new requirements, rather than all of their funding.

Me, I’m taking the rest of the day off. As an old libertarian I mourn for the freedom we just lost. It is another reason, in a long, long line of them, to clean that cesspool of Washington DC out. And, frankly, perhaps it is time we contemplated bolder measures.

Sorry … but this ruling all but guarantees the twilight of a great experiment. It lasted over 200 years, but it is definitely in its nadir now. This only accelerates the decline. We’ve just put ourselves in the same place as Europe, and we see who gloriously that’s going, don’t we?

Just some random thoughts as we await the Supreme Court ruling on healthcare.

I can’t help thinking the title is precisely what is on the line today. Given the implications of upholding that odious law, I can’t help but feel this is indeed the most momentous decision in my lifetime. Oh, certainly, there have been many other important ones, to be sure, but never one that had the potential, at least as I see it, to give government carte blanc to expand and intrude into my life.

I’ve said it often, liberty (freedom) equals choice. Today’s decision will either uphold our ability to make individual choices (to include not having health insurance for whatever reason) in our lives or limit them – severely.

You know, when I was a kid I had to read the Constitution. I didn’t find it either difficult to read or understand. Yet since then, we’ve seen veritable oceans of words telling us what we read and the common understanding of what those words in the Constitution mean isn’t what they really mean. And the way the Constitution is treated by our politicians is simply shameful (and that applies to both sides).

It has also been ironic to me to see the “living Constitution” crowd whine and complain that the SCOTUS may be overturning “years of precedent”. That’s a true traditionalist argument. In fact, though, if it does strike down the mandate, then it will be a traditionalist ruling.

I’m not sure how the left will reconcile that without their heads exploding.

I’m also convinced that even if overturned, either partially or completely, this is only the beginning of the fight to have government take over health care. Next step? Single payer.

In fact, there are probably many on the left who actually hope this monstrosity will be overturned so they can proceed to what has always been the extreme left’s dream – single payer, government run health care. And, of course, Medicare provides precedence for that, doesn’t it.

So as we sit here waiting and hoping, it might behoove us to consider that even if the decision goes as we hope it will go, spiking the ball will be premature.

A ruling against the law won’t signal the end of this fight. I’m afraid it will only signal the end of round 1 of a multi-round championship fight.

File this under speculation, because that’s essentially what it is (but you have to do a little of it every now and then, and besides, it’s a sport when talking about pending SCOTUS decisions), but still speculation with some possibility of being accurate.

It seems, according to Avik Roy, that June 25th is most likely the day we will learn the fate of ObamaCare from the Supreme Court.

“Setting aside the ACA cases,” he notes, “the Court essentially has twelve other decisions to hand down.” In addition, “in recent Terms, the Court has handed down opinions on Wednesdays or Thursdays of both of the last two weeks of the Term, in addition to the regularly scheduled Mondays. And the Court has already announced that it will issue one or more opinions next Thursday, June 21.” Worth also noting, he writes, “the Court almost never issues more than four or five opinions on the same day.”

Hence, if the court issues four or five opinions each on Monday, June 18 and Thursday, June 21, that would leave between two and four opinions for the last scheduled day for reading opinions: Monday, June 25.

And how will the ruling go? Well, Ruth Bader Ginsberg has said previously that there are some “sharp divides” among the justices.

But, again according too Roy, Ginsberg may have also hinted she’s on the “dissenting” side, meaning that she’s on the minority side of the decision. The basis for that claim?

In her ACS remarks, Ginsburg suggested that she might be on the dissenting side of the case. “I have spoken on more than one occasion about the utility of dissenting opinions, noting in particular that they can reach audiences outside the court and can propel legislative or executive change,” said Ginsburg, in the context of a 2007 pay discrimination case.

Or that may signal nothing at all (she may simply have been speaking academically about “dissenting opinions”). The key, if we accept the premise that she’s on the dissenting side of this particular ruling is what that means.

Roy mentions that the divide may not be associated with killing the mandate – there may be more than 5-4 agreement on that subject (he suggests it is almost a given that Kennedy will join the conservatives on the court to kill the mandate). The divide may be with what to do with the law if the mandate is killed:

The key question is: how much of the rest of the law should be struck down along with it?

Ginsburg wittily put it this way: “If the individual mandate, requiring the purchase of insurance or the payment of a penalty, if that is unconstitutional, must the entire act fall? Or, may the mandate be chopped, like a head of broccoli, from the rest of the act?”

My understanding—again, from third-hand sources—is that this question of severability is the subject of intense debate among the justices, even now. It’s entirely unclear whether the Court will strike down the mandate and two related provisions—what I’ve called the “strike three” scenario; or take down the entirety of Title I, where the law’s restructuring of the private insurance market resides; or overturn the whole law. Indeed, it is probable that the Court has not yet decided how it will rule on this question.

As far as I’m concerned, I’d like to see the entire law struck down. However, I’m now wondering whether or not that will play out.

Roy also mentions Antonin Scalia’s recent book and asserts that it hints that Scalia is on the side of dumping the mandate and the law in its entirety. He wonders if Scalia, given his writing about the scale of the Commerce Clauses expansion and Scalia’s unhappiness with that, has chosen ObamaCare as the case he’s chosen for judicial pushback.

So, again, based on this speculation, one might surmise that the court has found the individual mandate to be unconstitutional, but is struggling with how much or how little of the law to strike down.

Of course, the individual mandate is the heart and soul of the bill. It is the payment mechanism that undergirds the entire ponzi scheme program. No mandate, no money, no expanded risk pool, not much of anything if it goes.

So perhaps even if the court leaves much of ObamaCare standing, it will end up being a Pyrrhic victory for its supporters as the law will then be unsustainable as it exists (minus the mandate).